Friday, October 28, 2005

UK Proposal for Smoke-Free Workplaces Turns into a Joke

The UK Health Secretary this week announced that the Government's approach to dealing with what it states is a serious occupational health threat to food service workers - secondhand smoke - will be to force business owners to decide whether to allow smoking or to serve food.

After a lengthy and highly publicized consideration of the issue, the proposal finally introduced into Parliament would ban smoking in all restaurants (pubs) that serve food, but would exempt pubs that only serve alcohol, not food.

According to the Independent: "When they [Department of Health officials] looked at the manifesto and the very difficult balance they were trying to strike between protecting employees and respecting the rights of the minority, 'to do something that is perfectly legal', it was decided the right balance was the one contained in the manifesto - although there were disadvantages which ever way they went."

According to a survey by the Publican, the industry magazine, 20% of pubs in England and Wales reported that in response to the new law (as proposed) they would stop selling food in order to continue to allow patrons to smoke. Based on industry statistics, that amounts to 8,500 pubs which would switch from food-serving to alcohol only-serving establishments and continue to allow smoking.

These figures throw into question the Health Secretary's assertion that "the measures proposed would increase that [the proportion of workers with a smoke-free environment] to 99%, so 12 million more workers would be included." Her claim depends upon an assumption that none of the existing food-serving pubs would choose to continue to allow smoking, which appears to be quite inaccurate.

The basic rationale for the proposal was described by the Department of Health as follows: "We believe that these proposals offer the right balance between reducing the public health risk whilst allowing an element of choice for those who do want to smoke with a drink to do so in a way which has minimal impact on other people."

The Rest of the Story

What appears to have previously been a health debate has rapidly deteriorated into a big joke. The proposed policy is, I believe, not a public health policy at all. It is simply a completely unwarranted and arbitrary intrusion of the government into basic business decisions of pub owners in England and Wales.

Why? Because the proposed policy in no way guarantees health protection for a single individual. What the proposal basically amounts to is a law to force pubs to choose between allowing smoking and serving food. But that is a choice that will be left up to them. The government is not truly proposing to regulate whether smoking occurs or not, it is merely regulating the type of business practices that must be followed by owners who make the decision to allow smoking.

So what the government is basically saying is: We don't care if you allow smoking or not. But if you do allow smoking, we're going to make it harder for you to gain customers and make profits by prohibiting you from serving food!!!

That's not a public health policy - it is a severe and completely unjustified and unwarranted intrusion into free enterprise.

To make matters worse, the Department of Health justified its proposed policy by explaining that it wanted to "offer the right balance between reducing the public health risk whilst allowing an element of choice for those who do want to smoke with a drink." But if you're going to allow an element of choice for those who do want to smoke with a drink, then there is no reason not to allow that same element of choice for those who want to smoke with their food.

So if what you're after is allowing an "element of choice," then why not simply exempt establishments that serve food or drink, thus allowing an element of choice for those who want to smoke with their food or drink?

Further, the Department of Health states that its goals were to strike a balance between "protecting employees and respecting the rights of the minority to do something that is perfectly legal." Well if respecting the rights of the minority to do something that is perfectly legal means allowing them to continue to smoke while drinking, then doesn't that respect also have to apply to allowing them to continue to smoke while eating? Once you recognize that there is a "right" to do something that is perfectly legal, then it seems to me that you cannot infringe upon that right.

Were I a member of Parliament, I would vote against this proposal because I do not feel that it is an appropriate public health policy and I don't think it is justified by any valid public health reasoning. It is simply a law that arbitrarily requires a business decision to be made, and in such a way that it simply adds an arbitrary burden to owners who decide to continue to allow smoking in their establishments.

As such, it is an unwarranted government intrusion into private business.

If there were some rational health-related reason why serving food were incompatible with allowing smoking, while serving alcohol was not, then the policy might be justified. But there is no such reason; thus, there is no justification for the policy.

If the health risks of secondhand smoke are as bad as the Department of Health claims ("A non-smoker, living or working in a very smoky environment over a prolonged period, is 20-30 per cent more likely to get cancer than a non-smoker who does not. Hundreds of people die every year in the UK as a result of high levels of exposure to passive smoke."), then it should eliminate this health hazard by eliminating smoking in all pubs. If it isn't that bad, then the government has no business intruding into the decisions of pub owners regarding what types of food or drink they can serve in their establishments. But the Department has to make up its mind. Which is it?

I understand and respect the fact that many of my readers are not convinced that secondhand smoke is a serious health threat and thus they do not support smoke-free laws. That reasoning makes perfect sense.

But I cannot respect the fact that in 2005, public health practitioners who are convinced that secondhand smoke is a serious health threat would support a policy that creates an arbitrary unlevel playing field for businesses (as they did in Georgia and in Indianapolis). If it's that serious a threat, then get rid of it. If not, then leave the poor bar and restaurant owners alone.

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About Me

Dr. Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health. He has 32 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at CDC, where he conducted research on secondhand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. He testified in the landmark Engle lawsuit against the tobacco companies, which resulted in an unprecedented $145 billion verdict against the industry. He teaches social and behavioral sciences, mass communication and public health, and public health advocacy in the Masters of Public Health program.